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Mungia R, Funkhouser E, Lobbezoo F, Verhoeff MC, Gilbert GH. Practice-based research in dentistry: Exploring methodologies, benefits, and challenges. J Oral Rehabil 2024. [PMID: 39152542 DOI: 10.1111/joor.13843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 06/25/2024] [Accepted: 08/07/2024] [Indexed: 08/19/2024]
Abstract
BACKGROUND Practice-Based Research Network (PBRN) studies typically assess the effectiveness of clinical interventions in settings that match real-world conditions. Dental PBRNs have the capacity to amass, identify, and analyze vast amounts of data from patient populations that include diverse racial, ethnic, socio-economic, and geographic backgrounds. These dental studies encompass a broad spectrum of healthcare aspects, including prevention, diagnosis, symptom and disease treatment, quality enhancement, and care coordination. METHODS An extensive range of research methodologies can be employed within dental PBRNs to investigate these topics, including randomized controlled trials. Dental PBRNs have evolved from primarily focusing on case observations to leveraging advanced network infrastructure and collaborating across multiple regional and national sites. In addition to producing numerous high-impact peer-reviewed publications, study results have led to improved clinical care. However, PBRNs encounter challenges, such as the sustainability of research capacity (relying heavily on ongoing support from funding agencies), diverse research cultures, and an imperative to design studies that are both feasible and relevant to everyday clinical practice. Recognizing the pivotal role of real-world evidence, it is important to have sustained investment in dental PBRN infrastructure and feasible opportunities for practitioners to participate in network activities nationwide. CONCLUSION Practice-Based Research Network studies capitalize on an important research context within which to investigate a range of clinical topics that can employ multiple research methodologies. However, sustaining productive networks requires strategic effort, ongoing financial support, and customized organizational skills.
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Affiliation(s)
- Rahma Mungia
- Department of Periodontics, School of Dentistry, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Ellen Funkhouser
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Merel Charlotte Verhoeff
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Gregg H Gilbert
- Department of Clinical and Community Sciences, School of Dentistry, National Network Director, National Dental PBRN, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Abuhaloob L, El-Osta A, Newton T, Rawaf S, Banerjee A. Could the minimum intervention oral care framework help improve the quality of oral health delivery and access to NHS primary dental care? Br Dent J 2024:10.1038/s41415-024-7627-x. [PMID: 39143226 DOI: 10.1038/s41415-024-7627-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 04/05/2024] [Accepted: 04/09/2024] [Indexed: 08/16/2024]
Abstract
Access to NHS primary dental care services is a perennial issue in the UK. Two aspects must be considered when measuring access to dental care: 'entry access', which relates to service availability resulting in realised initial or continued access; and 'effective access', the delivery of effective, equitable and efficient care, which manifests as equitable and optimal outcomes of care. It is proposed that the minimum intervention oral care (MIOC) delivery framework provides a person-focused, prevention-based, susceptibility/needs-related, team-delivered approach to ensuring effective access to primary oral and dental care. A theory of change model could identify the key barriers to overcome the implementation of the MIOC approach, involving all key stakeholders in primary oral and dental care delivery.
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Affiliation(s)
- Lamis Abuhaloob
- WHO Collaborating Centre for Public Health Education and Training, Primary Care and Public Health, School of Public Health, Imperial College London, 90 Wood Lane, W12 0BZ, United Kingdom.
| | - Austen El-Osta
- Self-Care Academic Research Unit (SCARU), Imperial College London, Department of Primary Care and Public Health, Imperial College School of Public Health, 90 Wood Lane, W12 0BZ, United Kingdom
| | - Tim Newton
- Centre of Oral Clinical Translational Sciences/Conservative & MI Dentistry, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Great Maze Pond, London, SE1 9RT, United Kingdom
| | - Salman Rawaf
- WHO Collaborating Centre for Public Health Education and Training, Primary Care and Public Health, School of Public Health, Imperial College London, 90 Wood Lane, W12 0BZ, United Kingdom
| | - Avijit Banerjee
- Centre of Oral Clinical Translational Sciences/Conservative & MI Dentistry, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Great Maze Pond, London, SE1 9RT, United Kingdom
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Cunningham IM, Gormley M, Neville P. Contemporary dental student professionalism: moving towards a macro-level perspective. Br Dent J 2024; 236:631-636. [PMID: 38671122 PMCID: PMC11052704 DOI: 10.1038/s41415-024-7297-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 11/17/2023] [Accepted: 11/24/2023] [Indexed: 04/28/2024]
Abstract
Defining professionalism and developing educational interventions that foster and assess student professionalism are integral to dental education. Nevertheless, conceptual, methodological and pedagogic differences define the academic field, leaving students, educators and the profession itself struggling to make meaningful progress on how best to elicit and monitor dental student professionalism. This article proposes that more progress can be made on this important issue when a contextualised, sociological assessment of dentistry and dental professionalism is undertaken. We contend that identifying some of the socio-cultural demands in UK dental students' lives, and acknowledging how these pressures shape their interactions with the UK dental education system, provides a nuanced and contemporaneous understanding of what it means to be an oral health care professional at a time of social and health care upheaval. Dental educators can use this insight to work towards being more understanding of and responsive to dental student professional development.
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Affiliation(s)
| | - Mark Gormley
- Consultant Senior Lecturer in Oral Surgery, Bristol Dental School, University of Bristol, UK
| | - Patricia Neville
- Senior Lecturer, Bristol Dental School, University of Bristol, UK
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Sindhusha VB, Rajasekar A. Assessment of Clinical and Patient-Centered Outcomes in Nonsurgical Periodontal Therapy. Cureus 2024; 16:e56464. [PMID: 38638755 PMCID: PMC11024879 DOI: 10.7759/cureus.56464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 03/19/2024] [Indexed: 04/20/2024] Open
Abstract
Aim The study was conducted to assess the clinical and patient-centered outcomes among the patients who had undergone nonsurgical periodontal therapy (NSPT). Methodology The participants for this study were 40 individuals with generalized chronic periodontitis. Numerous clinical parameters including clinical attachment level (CAL), probing pocket depth (PPD), plaque index (PI), and gingival index (GI) were evaluated along with the administration of a customized questionnaire before and after three months of therapy to evaluate patient-centered outcomes. Results Clinical parameters showed significant (p < 0.05) improvement post-NSPT. There was 100% satisfaction in few patient-centered outcomes such as bleeding gums, bad breath, food entrapment, and mobility. Conclusion A significant improvement in the clinical parameters does not guarantee improvement in patient-centered outcomes. Achieving the improvement in patient-centered outcomes can improve the overall quality of life (QOL), marking this a holistic treatment.
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Affiliation(s)
- Vyshnavi B Sindhusha
- Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Arvina Rajasekar
- Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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Zhang T, Mohsen M, Abbaticchio A, Battistella M. Patients' experiences of medication management while navigating ongoing care between outpatient services: A qualitative case study of patients on hemodialysis. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2024; 13:100418. [PMID: 38374965 PMCID: PMC10875289 DOI: 10.1016/j.rcsop.2024.100418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/21/2024] Open
Abstract
Background Patients on hemodialysis have complex medical diagnoses and medication regimens, requiring access to numerous health services and consultation with various healthcare providers. While interprofessional collaboration can optimize care among hemodialysis patients, these patients commonly experience medication-related problems and frequent hospitalizations resulting from miscommunications and mismanagement of medications. Objectives This study aims to capture the lived experiences of patients on hemodialysis to reveal their medication management needs as they navigate ongoing care between various outpatient services. Methods A qualitative methodology was used to explore the perspectives of hemodialysis patients. One-on-one, in-person, semi-structured interviews were conducted at an outpatient hemodialysis clinic located inside an urban teaching hospital. English-speaking adults 18 years and older who have been followed at the clinic for at least three months were selected through random, convenience sampling. Interviews were recorded and transcribed verbatim. Patients were recruited and data were collected iteratively and continued until data saturation was reached. Data was analyzed through the lens of the Picker Principles of Patient Centered Care using a general inductive approach. Results A total of nine interviews were conducted. Two major themes, medication management and care navigation, were identified. Though patients had a wealth of knowledge about their medications, and they were motivated to self-manage their medications to enhance their well-being, they experienced barriers with medication management. Patients further expressed challenges with navigating care and spoke of the importance of having good rapport with healthcare providers who are attentive to their needs. Conclusions The results revealed a need for improved support for self-care and interprofessional collaboration to possibly reduce the burden of medications and care fragmentation experienced by patients and improve continuity of care for patients.
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Affiliation(s)
- Tracy Zhang
- Leslie Dan Faculty of Pharmacy, University of Toronto, Ontario, Canada
- Department of Nephrology, Toronto General Hospital – University Health Network, Ontario, Canada
| | - Mai Mohsen
- Leslie Dan Faculty of Pharmacy, University of Toronto, Ontario, Canada
- Department of Nephrology, Toronto General Hospital – University Health Network, Ontario, Canada
| | - Angelina Abbaticchio
- Department of Nephrology, Toronto General Hospital – University Health Network, Ontario, Canada
| | - Marisa Battistella
- Leslie Dan Faculty of Pharmacy, University of Toronto, Ontario, Canada
- Department of Nephrology, Toronto General Hospital – University Health Network, Ontario, Canada
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Adams C, Harrison R, Iqbal MP, Schembri A, Walpola R. From Detractors to Promoters: A comparative analysis of patient experience drivers across Net Promoter Score subcategories. Int J Nurs Pract 2024; 30:e13197. [PMID: 37648254 DOI: 10.1111/ijn.13197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 08/12/2023] [Accepted: 08/15/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND The utilization of patient experience surveying by health care institutions has become increasingly prevalent, yet its effectiveness in promoting quality improvement remains uncertain. To enhance the utility of patient feedback, the examination of free-text comments may provide valuable insights to guide patient experience strategy. AIMS This study aims to explore the utility of free-text comments and identify key differences for patient experience drivers between Net Promoter Score (NPS) subcategories of Detractors, Passives, and Promoters. METHODS Evaluation and classification of comments was conducted using the eight Picker Principles of Person Centred Care, with descriptive analysis of patient comments performed on the NPS data. RESULTS Analysis of patient NPS comments can be classified into three key drivers: "feeling well-treated" (for Detractors), "feeling comfortable" (for Passives), and "feeling valued" (for Promoters). Specifically, Detractor comments provided the most comprehensive and detailed feedback to guide patient experience improvement activities. CONCLUSION This study highlights differences between NPS subcategories, particularly regarding aspects of safety, comfort, and feeling valued. Comments from Detractor respondents may be especially useful for guiding quality improvements due to increased specificity and insights. These results also emphasize the essential nature of empathy and compassionate interactions between patients and clinicians to achieve the highest level of patient satisfaction and experience.
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Affiliation(s)
- Corey Adams
- Australian Institute of Health Innovation (AIHI), Macquarie University, Sydney, Australia
| | - Reema Harrison
- Australian Institute of Health Innovation (AIHI), Macquarie University, Sydney, Australia
| | - Maha Pervaz Iqbal
- Australian Institute of Health Innovation (AIHI), Macquarie University, Sydney, Australia
| | | | - Ramesh Walpola
- School of Health Sciences, University of New South Wales (UNSW), Sydney, Australia
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Adjei ANA, Donkor A, Wiafe YA, Anyitey-Kokor IC, Hyde E. Elements of person-centred diagnostic imaging care in low-and middle-income countries: A systematic review. Radiography (Lond) 2024; 30:394-407. [PMID: 38176130 DOI: 10.1016/j.radi.2023.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 12/21/2023] [Accepted: 12/25/2023] [Indexed: 01/06/2024]
Abstract
INTRODUCTION Diagnostic imaging professionals are trained to deliver safe and high-quality person-centred radiographic diagnostic imaging care. The term person-centred care has been described as a confused concept without a unified definition. This systematic review identified the elements that have been used to measure person-centred care in diagnostic imaging in low- and middle-income countries (LMICs). METHODS A systematic review was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. Embase, MEDLINE and Cochrane library were searched. Bias was assessed using the Critical Appraisal Skill Programme and Mixed Method Appraisal Tool. A narrative synthesis guided by the Picker Principles of person-centred care was undertaken. RESULTS Of the 4482 articles identified, 26 articles were included. The studies were from 12 LMICs. Synthesis of the literature generated six themes, namely access to high quality and safe diagnostic imaging care, effective communication and shared diagnostic imaging decision making, suitable diagnostic imaging environment for physical comfort, respectful and compassionate diagnostic radiographers, effective coordination of diagnostic imaging care process, and family and friends' involvement in diagnostic imaging care. CONCLUSION Medical imaging facilities in most LMICs continue to struggle with issues of access, safety, quality, and responsiveness to the needs of patients. The need for innovative person-centred diagnostic imaging care interventions in LMICs has become urgent. IMPLICATIONS FOR PRACTICE If diagnostic imaging services in LMICs are to move beyond the current models of limited person-centred access to care, a greater focus on systems thinking is required. It is imperative to involve all stakeholders, not only patients and radiographers, but also policymakers whose works impact on equitable access to diagnostic imaging services.
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Affiliation(s)
- A N A Adjei
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - A Donkor
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; IMPACCT, Faculty of Health, University of Technology Sydney, Australia.
| | - Y A Wiafe
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - I C Anyitey-Kokor
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - E Hyde
- Provost for Learning & Teaching, University of Derby, United Kingdom.
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Böhme Kristensen C, Asimakopoulou K, Scambler S. Enhancing patient-centred care in dentistry: a narrative review. Br Med Bull 2023; 148:79-88. [PMID: 37838360 PMCID: PMC10724466 DOI: 10.1093/bmb/ldad026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/07/2023] [Accepted: 09/19/2023] [Indexed: 10/16/2023]
Abstract
INTRODUCTION Patient-centred care (PCC) is widely used within the medical setting, but there is a need for more research on PCC implementation in dentistry. SOURCES OF DATA A narrative review was conducted with literature identified from the Ovid Interface, including several databases such as Embase and Medline. AREAS OF AGREEMENT PCC is associated with better health outcomes for patients, and greater work satisfaction among healthcare professionals. AREAS OF CONTROVERSY Efforts to implement PCC in dentistry are lacking due to several issues including non-consensus about PCC definition and lack of explicit guidelines on how to implement PCC in dentistry. GROWING POINTS AND AREAS TIMELY FOR DEVELOPING RESEARCH A theory-derived model of PCC explicitly designed for the dental setting was identified. This serves as a starting point to enhance PCC in dentistry, though further research is needed to empirically test the implementation of this model.
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Affiliation(s)
- Camilla Böhme Kristensen
- Faculty of Dentistry Oral & Craniofacial Sciences, Centre for Host-Microbiome Interactions, King’s College London, London SE1 9RW, UK
| | - Koula Asimakopoulou
- Visiting Professor of Health Psychology, Faculty of Dentistry Oral & Craniofacial Sciences, Centre for Host-Microbiome Interactions, King's College London, London SE1 9RW, UK
| | - Sasha Scambler
- Faculty of Dentistry Oral & Craniofacial Sciences, Centre for Host-Microbiome Interactions, King’s College London, London SE1 9RW, UK
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Lin GSS, Goh SM, Halil MHM. Unravelling the impact of dental workforce training and education programmes on policy evolution: a mixed-method study protocol. Health Res Policy Syst 2023; 21:95. [PMID: 37700266 PMCID: PMC10496306 DOI: 10.1186/s12961-023-01048-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 09/02/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND The dental workforce plays a crucial role in delivering quality oral healthcare services, requiring continuous training and education to meet evolving professional demands. Understanding the impact of dental workforce training and education programmes on policy evolution is essential for refining existing policies, implementing evidence-based reforms and ensuring the growth of the dental profession. Therefore, this study protocol aims to assess the influence of dental workforce training and education programmes on policy evolution in Malaysia. METHODS A mixed-method research design will be employed, combining quantitative surveys and qualitative interviews. Stakeholder theory and policy change models will form the theoretical framework of the study. Participants from various stakeholder groups will be recruited using purposive sampling. Data collection will involve surveys and one-on-one semi-structured interviews. Descriptive statistics, inferential analysis and thematic analysis will be used to analyse the data. Integration of quantitative and qualitative data will be used to provide a comprehensive understanding of the data. DISCUSSION This study will shed light on factors influencing policy decisions related to dental education and workforce development in Malaysia. The findings will inform evidence-based decision-making, guide the enhancement of dental education programmes and improve the quality of oral healthcare services. Challenges related to participant recruitment and data collection should be considered, and the study's unique contribution to the existing body of knowledge in the Malaysian context will be discussed.
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Affiliation(s)
- Galvin Sim Siang Lin
- Department of Dental Materials, Faculty of Dentistry, Asian Institute of Medicine, Science and Technology (AIMST) University, 08100, Bedong, Kedah, Malaysia.
| | - Shu Meng Goh
- Department of Public Health Medicine, Faculty of Medicine and Health Science, Universiti Sabah Malaysia, 88400, Kota Kinabalu, Sabah, Malaysia
| | - Mohd Haikal Muhamad Halil
- Department of Restorative Dentistry, Kulliyyah of Dentistry, International Islamic University Malaysia, 25200, Kuantan, Pahang, Malaysia
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Khamnil Y, Kao-Iean S, Pisarnturakit PP. Scale development to measure the patient perception of patient-centered care of dentists in primary care settings of Thailand: a measurement invariance test. BMC Oral Health 2023; 23:626. [PMID: 37660040 PMCID: PMC10474778 DOI: 10.1186/s12903-023-03331-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/18/2023] [Indexed: 09/04/2023] Open
Abstract
BACKGROUND Patient-centered care is essential for providing quality services thoroughly at the primary care level, but it is unclear and lacks measurement. This study aimed to develop a reliable and valid instrument to measure patient perception of patient-centered care in primary dental care in Thailand and test the measurement invariance between large and small community hospitals. METHODS The initial set of 45 items for the patient perception of Patient-Centered Care of Dentist Scale (PCCDS-P version) was developed using a mixed-method approach, which included a literature review, a content validity test, cognitive interviews, and a pre-test. A multistage sampling strategy was used to recruit dental patients or their parents or caregivers from community hospitals across Thailand. Validity was examined through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Reliability was assessed using Cronbach's alpha coefficient and the intraclass correlation coefficient. Furthermore, a multi-group analysis was conducted to compare the responses of patients from large and small community hospitals. RESULTS Three hundred thirty-six and One thousand one hundred sixty-seven samples were randomized for EFA and CFA, respectively. The final PCCDS-P version consists of 7 factors with satisfactory reliability and validity and is composed of 42 items: dentist-patient relationship, disease-illness, integrated care, communication, shared information and decision-making, holistic, and empathy and anxiety management. The CFA showed the model fit was consistent with the entire sample. The metric invariance analysis showed that the factor loadings were invariant across patient groups. Overall, Cronbach's alpha coefficient and intraclass correlation coefficient were satisfactory. CONCLUSIONS The newly developed PCCDS-P version is composed of seven domains with 42 items with good reliability and validity, and it indicated measurement invariance across patients in large and small community hospitals.
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Affiliation(s)
- Yutthana Khamnil
- Graduate Program in Dental Public Health, Faculty of Dentistry, Chulalongkorn University, Patumwan, Bangkok, 10330, Thailand
| | - Surasak Kao-Iean
- Research Unit of CYD and Department of Educational Research and Psychology, Faculty of Education, Chulalongkorn University, Patumwan, Bangkok, 10330, Thailand
| | - Pagaporn Pantuwadee Pisarnturakit
- Department of Community Dentistry, Faculty of Dentistry, Chulalongkorn University, 34 Henry Dunant Road, Patumwan, Bangkok, 10330, Thailand.
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Mills I, Scambler S, Neville P, Asimakopoulou K. Developing a person-centred approach in dentistry beyond NHS recall intervals: a commentary. Br Dent J 2023; 235:24-28. [PMID: 37443223 DOI: 10.1038/s41415-023-6009-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 02/12/2023] [Accepted: 02/23/2023] [Indexed: 07/15/2023]
Abstract
Person-centred care (PCC) is acknowledged as a fundamental dimension of quality within health care and provides significant benefits for patients and clinicians. Models of PCC have primarily been developed from the medical literature, with limited consideration of their application within dentistry. The Personalised Care Institute was established to deliver education and training on PCC and is working with the Office of the Chief Dental Officer for England to develop resources on shared decision-making (SDM) to promote tailored recall intervals.This paper seeks to promote the value of PCC and SDM in delivering high-quality care but cautions against the use of generic models or training in view of the potential differences which may exist within dentistry, particularly general dental practice. The authors highlight the need to develop materials and training which are appropriate, contextualised and relevant to dentistry. The capacity and desire to deliver PCC is strongly influenced by the healthcare system which is in operation. The current units of dental activity (UDA) system operating in England would appear to act as a barrier to the delivery of PCC. Unless significant and rapid changes are introduced to the NHS Contract, UDA targets will continue to take precedence over PCC, SDM and tailored recall intervals.
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Affiliation(s)
- Ian Mills
- Peninsula Dental School, University of Plymouth, United Kingdom.
| | - Sasha Scambler
- Faculty of Dentistry, Oral and Craniofacial Sciences, King´s College London, United Kingdom
| | | | - Koula Asimakopoulou
- Faculty of Dentistry, Oral and Craniofacial Sciences, King´s College London, United Kingdom
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12
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Rapp L, Vergnes JN. Commentary on "The Lipstick". ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2023; 98:203. [PMID: 36696299 DOI: 10.1097/01.acm.0000919436.91549.e5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Affiliation(s)
- Lucie Rapp
- L. Rapp is a PhD student, Maintain Aging Research team, and researcher, INSERM Centre for Epidemiology and Population Health Research, Université Toulouse III Paul Sabatier, member, Cancer Ageing and Rejuvenation (CARe) Graduate School, and doctor of dental surgery, Conservative and Restorative Dentistry Department, Geriatric Dentistry, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; ; ORCID: 0000-0003-0908-694X
| | - Jean-Noel Vergnes
- J.-N. Vergnes is full professor, Maintain Aging Research team, INSERM Centre for Epidemiology and Population Health Research, Université Toulouse III Paul Sabatier, Centre Hospitalier Universitaire de Toulouse, Toulouse, France, and adjunct professor, Oral Health and Society Division, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada; Twitter: @JnVergnes; ORCID: 0000-0001-7322-6551
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Shakiba M, Iranparvar P, Jadidfard MP. The impact of sugar-sweetened beverages tax on oral health-related outcomes: a systematic review of the current evidence. Evid Based Dent 2022:10.1038/s41432-022-0830-1. [PMID: 36477678 DOI: 10.1038/s41432-022-0830-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 03/15/2022] [Indexed: 06/17/2023]
Abstract
Objective To provide a systematic overview of the impact of taxing sugar-sweetened beverages (SSBs) on oral health-related outcomes.Data sources For this PRISMA-compliant review, we searched PubMed, Scopus, Embase, Web of Science and Cochrane Central for relevant studies published from database inception to 27 August 2020.Data selection and extraction Two reviewers assessed the abstracts and then the full text of the studies. Primary studies that evaluated the impact of any kind of SSB tax on oral health-related outcomes (that is, decayed, missing and filled teeth, caries increment and dental treatment costs) were included.Data synthesis Of 503 search results, five studies met the inclusion criteria. All five were modelling studies, from which four studies predicted an SSB tax to have a positive impact on oral health-related outcomes, whereas one study in a developing country did not find an SSB tax to be solely successful. According to three studies, the younger population and men are likely to benefit the most from such a tax. One study demonstrated the benefits of an SSB tax to be potentially more significant among low-income individuals.Conclusion While no empirical studies are available to support the benefits of an SSB tax, the studies covered in this review altogether anticipate a positive impact. Furthermore, this review discusses some of the obstacles and limitations of implementing such a tax predicted by the included studies.
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Affiliation(s)
- Maryam Shakiba
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Cochrane Iran Associate Centre, National Institute for Medical Research Development, Tehran, Iran
| | - Pouria Iranparvar
- Cochrane Iran Associate Centre, National Institute for Medical Research Development, Tehran, Iran
| | - Mohammad-Pooyan Jadidfard
- Department of Community Oral Health, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Healing of Unilateral Maxillary Sinusitis by Endodontic and Periodontal Treatment of Maxillary Teeth. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58091302. [PMID: 36143979 PMCID: PMC9502478 DOI: 10.3390/medicina58091302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 09/14/2022] [Accepted: 09/15/2022] [Indexed: 11/20/2022]
Abstract
Inflammatory conditions of dental origin may spread to the bone tissue, causing its destruction, and to anatomical structures located in the vicinity of the tooth affected with inflammation. Maxillary premolars and molars may develop inflammatory lesions of the Schneiderian membrane and lead to tooth-borne lesions in the maxillary sinuses. Unilateral inflammation of the maxillary sinuses should be diagnosed and treated. The aim of this study was to determine whether and after what time from the applied endodontic or nonsurgical periodontal treatment the inflammation in the maxillary sinus was diminished (assessed by the decrease in the Schneiderian membrane hypertrophy). A retrospective study was performed to analyze the records of endodontically, periodontally, or endodontically-periodontally treated patients with unilateral inflammation of the maxillary sinuses along with diagnostic Cone Beam Computed Tomography. The method for determination of the inflammation was measurements registered in millimeters in Carestream software. The analysis included the situation before treatment and 3 months, 6 months, and 12 months after completion of the treatment. Regardless of the origin of the maxillary sinus lesion, healing of inflammation of the sinus has been reported after the implementation of causative treatment of the maxillary tooth. Dental treatment reduces the need to implement conservative or surgical ENT treatment.
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Rigo L, Basso K, Pauli J, Portilio M. Affect and cognition as antecedents of patients’ trust in the dentist. BRAZILIAN JOURNAL OF ORAL SCIENCES 2022. [DOI: 10.20396/bjos.v21i00.8667228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Aim: to evaluate the association of the patients’ perception about dentist’s affect and cognition on trust and, consequently, on intention to return and patient satisfaction with life. Methods: Analytical cross-sectional study conducted in patients’ adults and elderly at of two dentistry clinics in the south of Brazil. Patients had to have a previous relationship with the dentist (at least one previous consult) and 18 years of age or older. The data were collected through self-administrated questionnaire using measures adapted from other research, using structural equation modeling. We test using a chi-square difference test (p-value<0,05). Results: The mean age of the 197 patients was 37.0 years (σ = 15.5). The affect perceived by the patient at the dentist had a positive effect (β = .53) on the trust that the patient develops in relation to the dentist. The same is true for the effect of the rational or cognitive aspects perceived by the patient at the dentist (β = .41). The trust positively influences the patient’s intention to return to that dentist (β = .82). In addition, the intention to return to the dentist positively influences the patient’s satisfaction with life (β = .49). Conclusions: Affective and cognitive aspects positively influenced the patient’s trust in the dentist. The greater the patient’s trust in the dentist, the greater the intention to return to that dentist. Furthermore, a good relationship with the dentist improve the patient’s satisfaction with life.
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Nitschke I, Ulbrich T, Schrock A, Hopfenmüller W, Jockusch J. What Counts for the Old and Oldest Old?-An Analysis of Patient Criteria for Choosing a Dentist-Part II: Personal Characteristics and Soft Skills. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:8621. [PMID: 35886473 PMCID: PMC9316874 DOI: 10.3390/ijerph19148621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 02/01/2023]
Abstract
Soft skills include communication skills and personality traits that are important when choosing a dentist, but other factors within the dental office also seem to be important for patients. The aim of this study is to evaluate factors that are important to people in a dentist as well as characteristics of the ideal dentist and to evaluate possible age-, gender-, and residence of living specific differences. A telephone survey with participants aged 35 years or older (ag—age group: ag 1: 35−50 years, ag 2: 70−84 years, ag 3: >85 years) in three German cities was conducted. Data were analyzed with respect to gender and age. Most of the participants (n = 298, 64.2%), regardless of their own gender, age, or place of residence did not care about the gender of the dentist. In general, the price of the treatment does not play a role in choosing the ideal dentist. Women differ significantly from men in their choice of dentist (ANOVA p < 0.001 (preference of non-smoker), ANOVA p < 0.001 (preference, that the dentist does not smell of smoke, importance of appearance (ANOVA p < 0.001) and psycho-social skills, etc.). As age increases, professional experience and psycho-social competencies are rated as important. With the increase in age, the mean value of the desired years of professional experience increases without significant differences between age groups. The importance of advanced training (ANOVA p < 0.001; Bonferoni correction: significant difference between ag 1 and ag 2 p < 0.001, and ag 1 and ag 3 p < 0.001) decreases with age. Especially for participants aged 70 to 84 years, a relationship of trust is important. Between the places of residence, statistical differences for almost all surveyed items were found (e.g., importance that the dentist speaks the patients’ native language ANOVA p < 0.001, Bonferoni correction: significant difference between Berlin and Leipzig, Berlin and Mainz, and Leipzig and Mainz (each p < 0.001), dentist has a specialization ANOVA p < 0.001, Bonferoni correction: significant difference between Berlin and Leipzig and Berlin and Mainz (each p < 0.001), etc.). Dentists should be trained to develop psycho-social skills to meet the special demands of the increasing older population.
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Affiliation(s)
- Ina Nitschke
- Gerodontology Section, Department of Prosthodontics and Materials Science, University of Leipzig, Liebigstraße 12, 04103 Leipzig, Germany; (I.N.); (T.U.); (A.S.)
- Clinic of General, Special Care and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, CH-8032 Zurich, Switzerland
| | - Thomas Ulbrich
- Gerodontology Section, Department of Prosthodontics and Materials Science, University of Leipzig, Liebigstraße 12, 04103 Leipzig, Germany; (I.N.); (T.U.); (A.S.)
| | - Annett Schrock
- Gerodontology Section, Department of Prosthodontics and Materials Science, University of Leipzig, Liebigstraße 12, 04103 Leipzig, Germany; (I.N.); (T.U.); (A.S.)
| | - Werner Hopfenmüller
- Institute of Biometry and Clinical Epidemiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany;
| | - Julia Jockusch
- Gerodontology Section, Department of Prosthodontics and Materials Science, University of Leipzig, Liebigstraße 12, 04103 Leipzig, Germany; (I.N.); (T.U.); (A.S.)
- University Research Priority Program “Dynamics of Healthy Aging”, University of Zurich, CH-8050 Zurich, Switzerland
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17
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Nitschke I, von Chlingensperg R, Schrock A, Hopfenmüller W, Jockusch J. What Counts for the Old and Oldest Old?-An Analysis of Patient Criteria for Choosing a Dentist-Part I: Awareness and Selection Criteria, Infrastructure, and Dental Office Equipment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148307. [PMID: 35886163 PMCID: PMC9324363 DOI: 10.3390/ijerph19148307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/03/2022] [Accepted: 07/04/2022] [Indexed: 02/04/2023]
Abstract
Utilization of a dentist is influenced by many factors. The aim of this study is to present the factors relating to how patients become aware of a dentist, according to which criteria they select the dentist, and which factors in the infrastructure, equipment of dental offices, and human interactions are important for patients. A telephone survey with 466 participants (female 59.9%) in three age groups (ag 1: 35−50 years, ag 2: 70−84 years, ag 3: >85 years) in three German cities was conducted. Data were analyzed with respect to age, gender, and place of residence. Hardly any differences in the selection of the dentist and the selection criteria applied were found between the sexes, the age groups, or the places of residence. Recommendation seems to be the major aspect regarding how patients become aware of or select their dentist (n = 278, 65.6%), while modern technologies, e.g., the internet, play a subordinate role (n = 31, 7.3%). The unimportance of modern technologies increases significantly with the increase in age. As age increases, factors such as infrastructure (e.g., elevator available (ANOVA p < 0.001; Bonferoni correction: significant differences between ag 1 and ag 2 p < 0.001, ag 1 and ag 3 p < 0.001, and ag 2 and ag 3 p = 0.009); accessibility by wheelchair (ANOVA p < 0.001; Bonferoni correction: significant differences between ag 1 and ag 2 p = 0.006; and ag 1 and ag 3 p < 0.001); etc.) and dental office equipment become significantly important and influence the choice of dentist, while the importance of good parking facilities significantly decreased with age (ANOVA p = 0.003; Bonferoni correction: significant differences between ag 1 and ag 3 p = 0.004, and ag 2 and ag 3 p = 0.023). With increasing age, e.g., the importance of a television in the waiting room (ANOVA p = 0.012; Bonferoni correction: significant differences between ag 1 and ag 3 p = 0.014; and ag 2 and ag 3 p = 0.011), a modern waiting room (ANOVA p < 0.001; Bonferoni correction: significant differences between ag 1 and ag 3 p < 0.001; and ag 2 and ag 3 p < 0.001) or the possibility to visualize the oral situation on a screen decreases significantly (ANOVA p < 0.001; Bonferoni correction: significant differences between ag 1 and ag 2 p < 0.001; ag 1 and ag 3 p < 0.001, and ag 2 and ag 3 p < 0.001). If dentists want to welcome and treat older people, they should adapt the accessibility, infrastructure and equipment of their practice to the needs of older people in order to be able to guarantee continuous lifelong dental care regardless of the need for assistance or care.
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Affiliation(s)
- Ina Nitschke
- Gerodontology Section, Department of Prosthodontics and Materials Science, University of Leipzig, Liebigstraße 12, 04103 Leipzig, Germany or (I.N.); (R.v.C.); (A.S.)
- Clinic of General, Special Care and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland
| | - Richard von Chlingensperg
- Gerodontology Section, Department of Prosthodontics and Materials Science, University of Leipzig, Liebigstraße 12, 04103 Leipzig, Germany or (I.N.); (R.v.C.); (A.S.)
| | - Annett Schrock
- Gerodontology Section, Department of Prosthodontics and Materials Science, University of Leipzig, Liebigstraße 12, 04103 Leipzig, Germany or (I.N.); (R.v.C.); (A.S.)
| | - Werner Hopfenmüller
- Institute of Biometry and Clinical Epidemiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany;
| | - Julia Jockusch
- Gerodontology Section, Department of Prosthodontics and Materials Science, University of Leipzig, Liebigstraße 12, 04103 Leipzig, Germany or (I.N.); (R.v.C.); (A.S.)
- University Research Priority Program “Dynamics of Healthy Aging”, University of Zurich, 8050 Zurich, Switzerland
- Correspondence: or
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18
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Kankaala T, Kaakinen P, Anttonen V. Self‐reported factors for improving patient's dental care: A pilot study. Clin Exp Dent Res 2022; 8:1284-1294. [PMID: 35775664 PMCID: PMC9562830 DOI: 10.1002/cre2.625] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 06/16/2022] [Accepted: 06/21/2022] [Indexed: 11/17/2022] Open
Abstract
Objectives Patient‐centered approach can offer valuable information in improving dental care, but literature is scarce. This study aimed to evaluate self‐reported factors beneficial for attendance in dental care. Material and Methods Survey data were collected during the summer of 2020 comprising both structured questionnaires and an open question on factors considered beneficial for dental attendance. Voluntary patients over 15 years of age (n = 196, 98%) agreed to fill the questionnaires, and n = 112 of them (57%) also gave open commentary in an urgent dental care clinic, City of Oulu, Finland, comprising the study population. Dental fear was assessed by Modified Dental Anxiety Scale (MDAS) sum scores (min 5, max 25). All utterances (n = 181) on an open question were evaluated by inductive content analysis to create sub‐ and main categories. Covid‐19 pandemic case counts in Finland were low at the time of the survey, but their effect on seeking dental care was asked. The distribution of patients was evaluated by cross‐tabulation, considering their age, gender, and dental fear status; the significance level was p < .05. Results Females dominated slightly the study population (57%). The mean age of the respondents was 44 years. Half (50%) had moderate (MDAS score 10−18), and 10% had severe dental fear (≥19). The open responses could be categorized into four main categories. The largest main category by patient count concerned factors related to personnel (29%), followed by the patient (28%) and treatment (25%) related, and administrative factors (19%). Males chose factors falling into categories of administration and treatment while females chose patient and personnel‐related factors (p = .048). Compared to the rest, fearful persons (MDAS > 9) reported more often factors related to personnel and treatment (p = .03). Of all participants, 17% reported seeking less dental care during the pandemic. Conclusions Patients value dental personnel and treatment‐related factors, specifically those with fear.
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Affiliation(s)
- Taina Kankaala
- Research Unit of Population Health, Department of Cariology, Endodontology and Paediatric Dentistry University of Oulu 90014 Univeristy of Oulu Finland
- Dental Teaching Unit, City of Oulu Oulu Finland
| | - Pirjo Kaakinen
- Research Unit of Nursing Science and Health Management University of Oulu Oulu Finland
| | - Vuokko Anttonen
- Research Unit of Population Health, Department of Cariology, Endodontology and Paediatric Dentistry University of Oulu 90014 Univeristy of Oulu Finland
- Medical Research Center Oulu University Hospital and University of Oulu Oulu Finland
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19
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Moore R. Maximizing Student Clinical Communication Skills in Dental Education—A Narrative Review. Dent J (Basel) 2022; 10:dj10040057. [PMID: 35448051 PMCID: PMC9028015 DOI: 10.3390/dj10040057] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/18/2022] [Accepted: 03/24/2022] [Indexed: 11/29/2022] Open
Abstract
Dental student training in clinical communication skills and behavioral aspects of treatment are lauded as clinically meaningful in the dental education literature. However, many dental school curricula still only provide didactic, one-time coursework with multiple choice examination assessment and little or no student skill-activating activities. This article aims to review literature relevant to optimizing clinical communication and behavioral skills in dental education. The review summarizes findings of several relevant reviews and usable models to focus on four themes: (1) special characteristics of dentistry relevant to communication skill needs, (2) essential components of dental student learning of communications skills, (3) clinical consultation guides or styles and (4) optimal curricular structure for communication learning effectiveness. Contexts of communications in the dental chair differ from medical and other allied health professions, given the current mostly dentist-dominant and patient-passive relationships. Patient-centered communication should be trained. Dental students need more practical learning in active listening and patient-centered skills including using role-play, videotaping and ultimately, real patient training. Medical consultation guides are often unwieldy and impractical in many dental contexts, so a shortened guide is proposed. Communication skills need to be learned and taught with the same rigor as other core dental skills over the entire course of the dental curriculum.
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Affiliation(s)
- Rod Moore
- Institute of Dentistry and Oral Health, Aarhus University, 8000 Aarhus C, Denmark
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20
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Effect of Personalized Musical Intervention on Burden of Care in Dental Implant Surgery: A Pilot Randomized Controlled Trial. J Dent 2022; 120:104091. [DOI: 10.1016/j.jdent.2022.104091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 03/02/2022] [Accepted: 03/09/2022] [Indexed: 11/24/2022] Open
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21
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Stellrecht E, Theis-Mahon NR, Schvaneveldt N. ROLE OF LIBRARIANS AND INFORMATION PROFESSIONALS IN IDENTIFYING dPROS IN THE EVIDENCE. J Evid Based Dent Pract 2022; 22:101649. [DOI: 10.1016/j.jebdp.2021.101649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 10/05/2021] [Accepted: 10/06/2021] [Indexed: 10/20/2022]
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22
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Alaghemandan H, Ferdosi M, Savabi O, Yarmohammadian MH. Proposing A Framework for Accreditation of Dental Clinics in Iran. JOURNAL OF ORGANIZATIONAL BEHAVIOR RESEARCH 2022. [DOI: 10.51847/jvhevoxuwa] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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23
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What should people expect from person-centred dental visits? The Montreal-Toulouse Wheel of expectations. Br Dent J 2021; 231:249-253. [PMID: 34446900 DOI: 10.1038/s41415-021-3322-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 11/17/2020] [Indexed: 11/08/2022]
Abstract
There is a dearth of tools designed to inform people about what to expect from person-centred dental encounters and to guide them during the care process. This is why we propose the Montreal-Toulouse Wheel of patients' expectations for dental visits, which describes what people could expect during person-centred clinical encounters. The Wheel comprises four core expectations: 1) be understood; 2) be respected; 3) have power; and 4) be given enough time. It also includes three expectations that are more specific to the process of care: 5) be informed and understand; 6) share decisions with the dentist and even co-construct the treatment plan; and 7) be comfortable during clinical procedures and the whole care process. We also propose a Q-List to help patients reflect on their relationship with dental professionals and engage them in person-centred dental care. This Q-List describes the seven expectations of the Wheel and provides open-ended questions that we invite patients to reflect upon. We also hope that dental professionals and educators will find the Wheel and the Q-List useful to develop person-centredness and promote inclusive and equitable dentistry.
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Gray L, McNeill L, Yi W, Zvonereva A, Brunton P, Mei L. The "business" of dentistry: Consumers' (patients') criteria in the selection and evaluation of dental services. PLoS One 2021; 16:e0253517. [PMID: 34358252 PMCID: PMC8345823 DOI: 10.1371/journal.pone.0253517] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 06/07/2021] [Indexed: 11/18/2022] Open
Abstract
The dimensions of patient-centred care include not only clinical effectiveness and patient safety, but, importantly, the preferences of patients as consumers of healthcare services. A total of 249 participants were included in the study, with a balanced population proportional representation by age, gender, ethnicity and geographic region of New Zealand. An online questionnaire was used to identify participants’ decision-making process, and what factors and barriers for participants to seek dental treatment. Cross-tabulations, Spearman correlation analysis and Pearson Chi-Square analysis were used for the statistical analyses. Three most common reasons for visit were check-up (77%), clean (57%) and relief of pain 36%). A desire to treat a perceived problem was the most common encouraging factor to seek dental care. Cost was the most common barrier to seeking dental services. The majority of participants attended a private practice (84%), with convenience of location and referral from professionals the most likely to influence their choice. Participants felt the most important trait a dental practitioner could demonstrate was to discuss treatment options with them before any treatment. Dental check-up, teeth cleaning and relief of pain were the most common reasons for patients to choose dental services. Cost and ethnicity of the consumers had a significant impact on how dental services were perceived and sought. Dental practitioners may need to reorientate how they express value of oral health practice, not just in regard to communication with patients, but also with government funding agencies.
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Affiliation(s)
- Laura Gray
- Faculty of Dentistry, Department of Oral Sciences, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - Lisa McNeill
- Otago Business School, University of Otago, Dunedin, New Zealand
- * E-mail: (LMN); (LM)
| | - Weiming Yi
- Faculty of Dentistry, Department of Oral Sciences, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - Anastasia Zvonereva
- Faculty of Dentistry, Department of Oral Sciences, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - Paul Brunton
- Division of Health Sciences, University of Otago, Dunedin, New Zeland
| | - Li Mei
- Faculty of Dentistry, Department of Oral Sciences, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
- * E-mail: (LMN); (LM)
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Alrawiai S, Asimakopoulou K, Scambler S. Patient-Centred Care in Dentistry: Definitions and Models - Commentary. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2021; 25:637-640. [PMID: 33180971 DOI: 10.1111/eje.12629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 09/25/2020] [Accepted: 10/18/2020] [Indexed: 06/11/2023]
Abstract
Patient-centred care is an important approach that is currently being adopted, to varying degrees of success, in a number of healthcare settings, particularly in family medicine and nursing. However, patient-centred care is relatively understudied in dentistry. This commentary aims to provide a general overview of patient-centred care studies conducted in dentistry, of how the approach is defined in this setting, and of the different models that have aimed to operationalize the concept. This concept is particularly relevant to dental education as current guidelines for dentists encourage and require them to adopt different dimensions of this approach. In addition to policies and guidelines, there is evidence that suggests that the adoption of patient-centred care would result in positive outcomes.
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Affiliation(s)
- Sumaiah Alrawiai
- Department of Health Information Management & Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Koula Asimakopoulou
- Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Sasha Scambler
- Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
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26
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Denis F, Siu-Paredes F, Maitre Y, Amador G, Rude N. A qualitative study on experiences of persons with schizophrenia in oral-health-related quality of life. Braz Oral Res 2021; 35:e050. [PMID: 33759972 DOI: 10.1590/1807-3107bor-2021.vol35.0050] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 10/30/2020] [Indexed: 11/21/2022] Open
Abstract
Our study aimed to explore the views and experiences in oral health and oral-health-related quality of life (OHRQoL) of persons with schizophrenia (PWS) in order to expand the understanding of the factors that either limit or facilitate their healthcare pathway, which can ultimately optimize their oral health and/or OHRQoL. A qualitative study was conducted in France in the Côte d'Or department (530 000 in habitants) centered on PWS's perceived meanings regarding oral health or OHRQoL, and semi-structured individual interviews were used. A conventional content analysis approach was chosen in order to highlight unrevealed themes. A sample of 20 PWS (12 males; 8 females) with a median age was 45.8 (± 9.5) were recruited to assess views and experiences regarding OHRQoL, which were focused on three dimensions: an individual dimension related to experience of "oral symptoms", a second dimension related to experience of "stress and its management", and a third related to "Autonomy dimension in oral health". We showed that PWS clearly expressed their mental representations of oral health and OHRQoL. This study supports that PWS were able to define their needs and had the ability to discuss their oral health and OHRQoL. These finding could be used to support specific interventions for this population to better manage the negative impact of antipsychotics and help them to consult dentists on a regular basis.
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Affiliation(s)
- Frédéric Denis
- Université François-Rabelais, Faculté de Médecine, Santé, Tours, France
| | | | | | - Gilles Amador
- Université de Nantes, Faculté d'Odontologie, Nantes, France
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27
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Amin N, Cunningham SJ, Jones EM, Ryan FS. Investigating perceptions of patient-centred care in orthodontics. J Orthod 2020; 47:320-329. [DOI: 10.1177/1465312520952802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives: To assess and compare patient and clinician perceptions of patient-centredness for adults about to commence active orthodontic treatment, and to assess whether the following variables affected perceptions of patient-centredness: patient gender and age; clinician gender and grade; and stage of treatment. Design: A prospective, cross-sectional questionnaire study. Setting: Eastman Dental Hospital, UCLH NHS Foundation Trust. Participants: A total of 112 adult patients and 30 clinicians completed 224 questionnaires (112 patient and 112 clinician questionnaires). Methods: A validated, dyadic questionnaire, the ‘9-Item Patient Perception of Patient-Centredness’ (PPPC), was used to collect data from both patients and their corresponding clinicians after initial assessment or records/treatment planning consultations. Total PPPC scores (possible score range = 9–36) were calculated for each patient and clinician to ascertain the extent to which they perceived they were engaging in patient-centredness, where higher scores corresponded with better performance. Results: Patients and clinicians perceived high engagement in patient-centredness with median scores of 32/36 and 29/36, respectively. There was a statistically significant difference between total scores with patients perceiving consultations to be more patient-centred than clinicians ( P < 0.001). None of the variables (patient gender and age, clinician gender and grade, stage of treatment) were statistically significant. Conclusion: Patients and clinicians both perceived high engagement in patient-centredness. Patients perceived consultations to be significantly more patient-centred than clinicians ( P < 0.001).
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Affiliation(s)
- Nima Amin
- Royal National ENT and Eastman Dental Hospitals, University College London Hospitals NHS Foundation Trust, London
- UCL Eastman Dental Institute, Rockefeller Building, London
| | | | - Elinor M Jones
- UCL Eastman Dental Institute, Rockefeller Building, London
| | - Fiona S Ryan
- Royal National ENT and Eastman Dental Hospitals, University College London Hospitals NHS Foundation Trust, London
- UCL Eastman Dental Institute, Rockefeller Building, London
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28
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Noushi N, Bedos C. Developing Person-Centred Dental Care: The Perspectives of People Living in Poverty. Dent J (Basel) 2020; 8:E82. [PMID: 32756307 PMCID: PMC7557589 DOI: 10.3390/dj8030082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/13/2020] [Accepted: 07/15/2020] [Indexed: 11/26/2022] Open
Abstract
Dentistry has seen a slow trend toward person-centred care (PCC), with most approaches developed by scholars who have tried to progress away from disease-centred care. Unfortunately, the perspectives and experiences of underprivileged people have not been considered in the development of these approaches. Our objective was thus to understand underprivileged people's experiences and expectations about dental care and contribute to the development of person-centred dentistry. We conducted a qualitative descriptive study with a sample of 13 people living in poverty. We used a maximum variation sampling strategy and selected them among the users of a free dental clinic in Montreal, Canada. We conducted semi-structured interviews that we audio recorded, transcribed verbatim, and thematically analysed. Our main finding is that participants wanted to feel human and respected by dentists. More specifically, they wanted to be more involved in the dental care process through quality time and empathetic conversations with the dentist. They also wished for an exchange of information free of technical terms and built on mutual trust. In conclusion, person-centred dental care models should emphasize empathy, trust, and quality care beyond technical skills. Clinicians should provide comprehensive information in dental encounters and treat their patients as whole persons.
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Affiliation(s)
- Nioushah Noushi
- Faculty of Dentistry, McGill University, Montréal QC H3A 1G1, Canada;
| | - Christophe Bedos
- Faculty of Dentistry, McGill University, Montréal QC H3A 1G1, Canada;
- School of Public Health, Université de Montréal, Montréal QC H3N 1X9, Canada
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Remote clinical consultations in restorative dentistry: a clinical service evaluation study. Br Dent J 2020; 228:441-447. [PMID: 32221448 DOI: 10.1038/s41415-020-1328-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Introduction Specialist consultant services in the UK NHS provide a decision-making support service to other health professionals. There is a drive to deliver this service in a more patient-centred, cost-effective and efficient manner. Remote clinical consultations (RCC), using secure, live, super-fast internet connectivity and high-resolution, multi-channel audio-visual streaming, has the potential for the delivery of this service.Aim To conduct a clinical service evaluation to assess the viability and efficiency of conducting a RCC for the management of primary care referrals in restorative dentistry, compared to an in-person consultation.Design A RCC was conducted for every participating patient and immediately followed with a 'verification' in-person consultation.Materials and method Twenty-three patients of even gender distribution participated in this study across the three specialisms of restorative dentistry. A thematic questionnaire was completed by each member of the study intervention team and the patient after each consultation.Results In all the cases, the consultant was able to conduct an effective and safe clinical consultation, not inferior to an in-person process, regardless of gender and age. The GDP, the nurse and the patient were able to participate effectively in the process and with each other.Conclusion This proof-of-concept study suggests that the RCC concept is a feasible way of delivering specialist consultations in restorative dentistry with high levels of patient acceptability and that it can be delivered in a practical and simple manner.
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Arrow P, Forrest H. Atraumatic restorative treatments improve child oral health-related quality of life: A noninferiority randomized controlled trial. Community Dent Oral Epidemiol 2020; 48:349-356. [PMID: 32424833 DOI: 10.1111/cdoe.12539] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 03/20/2020] [Accepted: 04/12/2020] [Indexed: 01/31/2023]
Abstract
OBJECTIVES Management of dental caries under dental general anaesthesia (DGA) in young children improves their quality of life. A randomized controlled trial was undertaken to test the changes in oral health-related quality of life among children treated under a DGA or managed using the Atraumatic Restorative Treatment and Hall crown approaches (ARTs). METHODS Children scheduled for a DGA for the management of dental caries after assessment at the Oral Health Centre of Western Australia were invited to participate. Inclusion and exclusion criteria were applied. Child oral health-related quality of life (COHRQoL) was evaluated through the Early Childhood Oral Health Impact Scale (ECOHIS) and the child-specific Caries Impacts and Experiences Questionnaire for Children (CARIES-QC) at baseline and 12 months after consent. The changes in child oral health-related quality of life were analysed on an intention-to-treat basis. Paired t-test and Wilcoxon's matched-pairs rank test were used for within-group comparison and t-test, Mann-Whitney test, and test of proportions for between-group comparisons. Linear regression was used for multivariable analyses of the follow-up scores. RESULTS Sixty-five parents/carers agreed to participate and were randomized (Test = 32; Control = 33). Mean age = 4.7 years, SD 1.1; 51% male. At baseline, there were no statistically significant differences in age and sex between the groups; however, the ARTs group reported higher ECOHIS scores. At follow-up, both the ARTs and DGA groups had lower ECOHIS scores (20.7 vs 12.9 and 14.4 vs 13.3, respectively) and CARIES-QC scores (12.6 vs 7.1 and 9.9 vs 8.4, respectively). The within-group differences in the ARTs group were statistically significant while the differences in the DGA group were not, P < .01 and P > .05, respectively. In a linear regression of the follow-up scores, being in the DGA group increased the follow-up scores, but it was no longer statistically significant while baseline impact scores were significantly associated with greater follow-up scores for both the ECOHIS and the CARIES-QC, P < .01. CONCLUSION The child oral health-related quality life among children scheduled for dental general anaesthesia improved after receiving minimally invasive, atraumatic restorative treatments of dental caries.
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Affiliation(s)
- Peter Arrow
- Dental Health Services, Perth, WA, Australia
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Duque AD, Malheiros Z, Stewart B, Romanelli HJ. Strategies for the prevention of periodontal disease and its impact on general health in Latin America. Section III: Prevention. Braz Oral Res 2020; 34:e025. [PMID: 32294678 DOI: 10.1590/1807-3107bor-2020.vol34.0025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 10/16/2019] [Indexed: 01/09/2023] Open
Abstract
Dental plaque removal and the understanding of risk factors, risk indicators and social determinants are important components in the prevention of periodontal disease. Periodontal diseases and dental caries are largely preventable conditions, but require a "common risk factor approach" with non-communicable diseases with the purpose of improving their prevention and control, and positive impact on health. The aim of this consensus was to identify the evidence and gaps in periodontal prevention in Latin American, and to propose individual and collective recommendations for the population, health professionals, dental practice and government. The prevention of periodontal diseases in Latin America has mainly been focused on oral hygiene instruction, use of toothbrushes and interproximal devices, but in some patients, it is necessary to use adjuncts to these measures, such as antimicrobial and/or probiotic products that are backed by broad scientific evidence. Some evidence has shown that there are inadequate knowledge, attitudes and practices among patients, dentist and other health professionals. The prevention of periodontal diseases and caries should be adopted as a healthy lifestyle routine, because of their local and systemic effects. Recently, new empowerment strategies have been proposed in order to generate behavioral changes. Periodontal diseases can often be prevented, or controlled by joined efforts between government health systems, scientific associations, universities, health professionals, private companies and communities. In conclusion, the relations between periodontal diseases, caries, healthy lifestyles and NCD's offer an ideal opportunity to change Latin American prevention strategies at both the individual level and population levels.
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Affiliation(s)
- Andrés Duque Duque
- Universidad CES, Faculty of Dentistry, Department of Periodontics, Medellin, Antioquia, Colombia
| | - Zilson Malheiros
- Latin American Oral Health Association - LAOHA, São Paulo, SP, Brazil.,Colgate-Palmolive Company, Piscataway, NJ, USA
| | - Bernal Stewart
- Latin American Oral Health Association - LAOHA, São Paulo, SP, Brazil.,Colgate-Palmolive Company, Piscataway, NJ, USA
| | - Hugo Jorge Romanelli
- Maimónides University, Faculty of Health Sciences, Department of Periodontics, Buenos Aires, Argentina
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Wong HM, Bridges SM, Ma KW, Yiu CKY, McGrath CP, Zayts OA. Advanced informatics understanding of clinician-patient communication: A mixed-method approach to oral health literacy talk in interpreter-mediated pediatric dentistry. PLoS One 2020; 15:e0230575. [PMID: 32196519 PMCID: PMC7083275 DOI: 10.1371/journal.pone.0230575] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 03/03/2020] [Indexed: 12/30/2022] Open
Abstract
Background In the clinical dental consultation, multi-party configurations predominate with the presence of parents/ primary caregivers in pediatric dentistry adding another layer of complexity. In managing child oral healthcare, parents/ primary caregivers are critical, especially in dental caries prevention. This study aimed (1) to identify the structure of oral health literacy (OHL) talk in interpreter-mediated pediatric dentistry and (2) to analyze interpreter contributions to the communication strategies: patient-centered direct interpreting (PC-DI), patient-centered mediated interpreting (PC-MI), clinician-centered direct interpreting (CC-DI), and clinician-centered mediated interpreting (CC-MI). Methods Visual text analysis (VTA) of video recorded pediatric clinical consultations in Hong Kong utilized Discursis™ software to illustrate temporal and topical structures and their distribution across turns-at-talk. Conversation analysis (CA) was applied to analyze turn-taking of the identified OHL talk qualitatively. The mixed-method approach of combining VTA and CA was applied to analyze the patterns and features of the recorded OHL talk. Results The conceptual recurrences of the 77 transcribed video recordings were plotted visually. CC- and PC-OHL talk were identified by the recurrence patterns of monochromatic and multi-colored triangular clusters formed by off-diagonal boxes, respectively. CA of interpreter-mediated turns supported earlier findings regarding patterns of MI in multilingual adult dental consultations; however, the role of the interpreter in parent/ primary caregiver education and patient management was more distinctive in the pediatric dentistry. Conclusions The mixed-method approach assisted in unpacking the complexities of the multi-party interactions, supported identification of effective communication strategies, and illustrated the roles of the dental professionals in initiating CC- and PC-OHL talk in pediatric dentistry. The intervention showed the implication of the professional education of evidence-based practices for clinicians in balancing agenda management and the communicative dimension of OHL with the help of VTA and CA in multilingual consultations.
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Affiliation(s)
- Hai Ming Wong
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
- * E-mail:
| | - Susan Margaret Bridges
- Faculty of Education/Centre for the Enhancement of Teaching and Learning, The University of Hong Kong, Hong Kong SAR, China
| | - Kuen Wai Ma
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Cynthia Kar Yung Yiu
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | | | - Olga A. Zayts
- School of English, Faculty of Arts, The University of Hong Kong, Hong Kong SAR, China
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Raja S, da Fonseca M, Rabinowitz EP. Patient preferences on sharing private information in dental settings. J Am Dent Assoc 2020; 151:33-42. [PMID: 31902397 DOI: 10.1016/j.adaj.2019.08.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 08/20/2019] [Accepted: 08/22/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND The authors conducted a study to understand patients' preferences and comfort levels in discussing personal medical, behavioral, and social information with their oral health care providers. METHODS A self-report survey was completed by US adults 18 years and older (N = 387) using Amazon Mechanical Turk, an online research portal for survey-based research. The survey assessed comfort discussing demographics, physical health, behavioral health, oral health, and living conditions with oral health providers. RESULTS Factor analysis suggested that participants were comfortable discussing demographics and standard dental questions but were less comfortable answering questions about trauma, stress, coping, and living and behavioral patterns. Demographics did not predict comfort with disclosure, and many participants did not feel personal information was relevant to oral health care. CONCLUSIONS Community education efforts can focus on helping patients understand how oral health is related to behavioral health and social conditions. PRACTICAL IMPLICATIONS Dental education should focus on helping oral health care providers communicate comfortably around these topics, balancing education with respect for a patient's willingness to disclose.
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Gogovor A, Valois MF, Bartlett G, Ahmed S. Support for teams, technology and patient involvement in decision-making associated with support for patient-centred care. Int J Qual Health Care 2019; 31:590-597. [PMID: 30407517 DOI: 10.1093/intqhc/mzy224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 08/21/2018] [Accepted: 10/26/2018] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Patient-centred care is recommended to transform healthcare delivery to improve the quality and safety of healthcare. This study aimed to assess the determinants of support for attributes of patient-centred care (PCC) from Canadian public and professionals' perspectives. DESIGN A national population-based survey, the Health Care in Canada Survey. SETTING Canada. PARTICIPANTS One-thousand Canadian adults, 101 doctors, 100 nurses, 100 pharmacists and 104 administrators, randomly selected from online panels based on multiple source recruitment. INTERVENTION None. MAIN OUTCOME MEASURE Support for PCC, assessed using a summary score across seven items. RESULTS Of 1000 Canadian public adults surveyed, 51% were female, 74% were living with another person, and 62% had at least one chronic condition. Only 18% of health professionals were working in teams. Multivariable regression models showed that work in teams (0.24, 95%CI: 0.20, 0.28), use of e-technology (0.29, 95%CI: 0.17, 0.42), and patient older age (0.59, 95%CI: 0.32, 0.86) and involvement in decision-making (0.42, 95%CI: 0.30, 0.55) were significantly associated with higher support for PCC while lower adherence to medications (-0.81, 95%CI: -1.16, -0.47) was associated with a decreased support for attributes of PCC. CONCLUSIONS The findings confirmed that perceptions of requiring health professionals to work in teams and the use of technology in healthcare are associated with support for PCC from both the public and health professionals. Programs to accelerate the implementation of healthcare teams supported by information and communication technologies are needed to deliver PCC, particularly for individuals living with chronic conditions.
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Affiliation(s)
- Amédé Gogovor
- Department of Medicine Division of Experimental Medicine, McGill University, Montreal, QC H4A 3J1, Canada.,Department of Clinical Epidemiology, Centre for Outcomes Research and Evaluation, Research Institute of McGill University Health Centre, Montreal, QC H4A 3S5, Canada
| | | | - Gillian Bartlett
- Department of Family Medicine, McGill University, Montreal, QC H3S 1Z1, Canada
| | - Sara Ahmed
- Department of Clinical Epidemiology, Centre for Outcomes Research and Evaluation, Research Institute of McGill University Health Centre, Montreal, QC H4A 3S5, Canada.,School of Physical and Occupational Therapy, McGill University, Montreal, QC H3G 1Y5, Canada
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Blum IR, Hooper S. Consent to Treatment in the Post-Montgomery Era: Principles and Implications for the Dental Team. Prim Dent J 2019; 8:40-48. [PMID: 31431205 DOI: 10.1308/205016819827103476] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This paper examines recent changes in relation to the legal and regulatory requirements around the consent process in the UK and how to protect patients' rights to make decisions about their treatment. In addition to the implications of the Montgomery case on UK law of consent, key governmental and professional body regulatory guidance on the subject of consent are taken into account and discussed to facilitate a robust and valid consent process in the dental care environment.
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Shrivastava R, Couturier Y, Kadoch N, Girard F, Bedos C, Macdonald ME, Torrie J, Emami E. Patients' perspectives on integrated oral healthcare in a northern Quebec Indigenous primary health care organisation: a qualitative study. BMJ Open 2019; 9:e030005. [PMID: 31366663 PMCID: PMC6677955 DOI: 10.1136/bmjopen-2019-030005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE Patient-centred care is considered to be an important element in the evaluation of integrated healthcare and has been effective in addressing oral health disparities. This study explored the patients' perspectives of patient-centred integrated care in oral health services integrated into a primary healthcare organisation serving a northern Quebec Cree population. DESIGN This study used a multiple case study design within a qualitative approach and developmental evaluation methodology. Two theoretical models, Picker's Principles of Patient-Centred Care and Valentijn's Rainbow Model of Integrated Care, guided data collection and data analysis. The thematic analysis included transcription, debriefing, codification, data display and interpretation. SETTING This study was conducted in purposefully selected four Cree communities of Northern Quebec. PARTICIPANTS Adult patients in need of oral healthcare and who attended the local dental clinic were identified and recruited by maximum variation sampling and snowball techniques. OUTCOME MEASURES Patients' perspectives of patient-centred integrated oral healthcare. RESULTS Data analysis generated six major themes: enhanced accessibility, creating supportive environment, building trust through shared decision making, appreciation of public health programmes, raising oral health awareness and growing cultural humility among healthcare providers. Patients identified the integration of dental care into primary healthcare with respect to co-location, provision of free oral healthcare services, care coordination and continuity of care, referral services, developing supportive environment, shared decision making, oral health promotion and culturally competent care. CONCLUSION These results confirmed that patient-centred care is an important element of integrated care. Patients valued the use of this concept in all domains and levels of integration. They recommended to further strengthen the clinical integration by involving parents in oral health promotion as well as optimising care coordination and empowering a supportive environment in organisational integration.
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Affiliation(s)
- Richa Shrivastava
- Faculty of Dentistry, Université de Montréal, Montréal, Québec, Canada
| | - Yves Couturier
- School of Social Work, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Naomi Kadoch
- Faculty of Dentistry, Université de Montréal, Montréal, Québec, Canada
| | - Felix Girard
- Faculty of Dentistry, Université de Montréal, Montréal, Québec, Canada
| | - Christophe Bedos
- Faculty of Dentistry, McGill University, Montréal, Québec, Canada
| | | | - Jill Torrie
- Public Health Department, Cree Board of Health and Social Services of James Bay, Mistissini, Québec, Canada
| | - Elham Emami
- Faculty of Dentistry, McGill University, Montréal, Québec, Canada
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Curtis S, Gurveer J, Gallagher JE. Clinical dental technicians in the United Kingdom: A qualitative understanding of the experiences, of practices and challenges of communication for dental professionals. Gerodontology 2019; 36:405-416. [PMID: 31347736 DOI: 10.1111/ger.12413] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 04/11/2019] [Accepted: 04/20/2019] [Indexed: 11/29/2022]
Abstract
AIM To investigate the roles and relationships of registered Clinical Dental Technicians (CDTs) in the dental team and healthcare systems, and their perspective as a professional group in the United Kingdom (UK). METHODS This qualitative study was conducted following a national questionnaire survey of CDTs, 18 of whom participated in semi-structured interviews; they were purposively sampled to represent the diversity and demography of CDTs. A topic guide, informed by the literature and survey findings, guided discussions which were recorded and transcribed verbatim. Drawing upon phenomenological and cultural relativistic theories, thematic analysis was conducted, thus enabling an "analytic story" of the lived experience to emerge. RESULTS Clinical dental technicians expressed pride, passion and satisfaction in their work yet feel misunderstood in their role. Experiences of being accepted and incorporated into the wider dental profession are strained. Ultimately, there is a complex web of inter-dependence between all actors-a triadic relationship-bounded by policymakers and regulators which directly impacts on best practice and the balance between collaboration and autonomy. Looking to the future, Ideal practice may involve different models of care, with examples of good practice emerging. CONCLUSION This paper provides a unique examination of the lived experience, feelings and relationships of CDTs. The perceptions of their role, their inter-professional relations and the progression as a professional group must be addressed, and their potential to work collaboratively actively engaged to serve our ageing population.
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Affiliation(s)
- Sarah Curtis
- Faculty of Dentistry, Oral & Craniofacial Sciences, Centre for Host Microbiome Interactions, King's College London, London, UK
| | - Jaggee Gurveer
- King's College Hospital, London, UK.,University of Kent, Canterbury, UK
| | - Jennifer E Gallagher
- Faculty of Dentistry, Oral & Craniofacial Sciences, Centre for Host Microbiome Interactions, King's College London, London, UK
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Watt RG, Daly B, Allison P, Macpherson LMD, Venturelli R, Listl S, Weyant RJ, Mathur MR, Guarnizo-Herreño CC, Celeste RK, Peres MA, Kearns C, Benzian H. Ending the neglect of global oral health: time for radical action. Lancet 2019; 394:261-272. [PMID: 31327370 DOI: 10.1016/s0140-6736(19)31133-x] [Citation(s) in RCA: 394] [Impact Index Per Article: 78.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 04/15/2019] [Accepted: 04/26/2019] [Indexed: 12/13/2022]
Abstract
Oral diseases are a major global public health problem affecting over 3·5 billion people. However, dentistry has so far been unable to tackle this problem. A fundamentally different approach is now needed. In this second of two papers in a Series on oral health, we present a critique of dentistry, highlighting its key limitations and the urgent need for system reform. In high-income countries, the current treatment-dominated, increasingly high-technology, interventionist, and specialised approach is not tackling the underlying causes of disease and is not addressing inequalities in oral health. In low-income and middle-income countries (LMICs), the limitations of so-called westernised dentistry are at their most acute; dentistry is often unavailable, unaffordable, and inappropriate for the majority of these populations, but particularly the rural poor. Rather than being isolated and separated from the mainstream health-care system, dentistry needs to be more integrated, in particular with primary care services. The global drive for universal health coverage provides an ideal opportunity for this integration. Dental care systems should focus more on promoting and maintaining oral health and achieving greater oral health equity. Sugar, alcohol, and tobacco consumption, and their underlying social and commercial determinants, are common risk factors shared with a range of other non-communicable diseases (NCDs). Coherent and comprehensive regulation and legislation are needed to tackle these shared risk factors. In this Series paper, we focus on the need to reduce sugar consumption and describe how this can be achieved through the adoption of a range of upstream policies designed to combat the corporate strategies used by the global sugar industry to promote sugar consumption and profits. At present, the sugar industry is influencing dental research, oral health policy, and professional organisations through its well developed corporate strategies. The development of clearer and more transparent conflict of interest policies and procedures to limit and clarify the influence of the sugar industry on research, policy, and practice is needed. Combating the commercial determinants of oral diseases and other NCDs should be a major policy priority.
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Affiliation(s)
- Richard G Watt
- WHO Collaborating Centre in Oral Health Inequalities and Public Health, Department of Epidemiology and Public Health, University College London, London, UK.
| | - Blánaid Daly
- Division of Child and Public Dental Health, Dublin Dental University Hospital, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Paul Allison
- Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Lorna M D Macpherson
- Department of Dental Public Health, School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | - Renato Venturelli
- WHO Collaborating Centre in Oral Health Inequalities and Public Health, Department of Epidemiology and Public Health, University College London, London, UK
| | - Stefan Listl
- Quality and Safety of Oral Healthcare, Department of Dentistry, Radboud University Medical Center, Radboud University, Nijmegen, Netherlands; Section for Translational Health Economics, Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Robert J Weyant
- Department of Dental Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Carol C Guarnizo-Herreño
- Departamento de Salud Colectiva, Facultad de Odontología, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Roger Keller Celeste
- Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Marco A Peres
- Menzies Health Institute Queensland and School of Dentistry and Oral Health, Griffith University, Gold Coast, QLD, Australia
| | - Cristin Kearns
- Department of Preventive and Restorative Dental Sciences and Philip R Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA
| | - Habib Benzian
- WHO Collaborating Centre for Quality-Improvement, Evidence-Based Dentistry, Department of Epidemiology and Health Promotion, New York University College of Dentistry, New York, NY, USA; New York University College of Global Public Health, New York, NY, USA
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Amorim LDP, Senna MIB, Alencar GP, Rodrigues LG, de Paula JS, Ferreira RC. User satisfaction with public oral health services in the Brazilian Unified Health System. BMC Oral Health 2019; 19:126. [PMID: 31238976 PMCID: PMC6593529 DOI: 10.1186/s12903-019-0803-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 05/31/2019] [Indexed: 12/20/2022] Open
Abstract
Background User satisfaction represents a patient-centered measure that should be used to assess the quality of oral health services. This study investigated the differences in user satisfaction with public oral health services according to the sociodemographic user profile and the quality of oral health services in primary health care in Brazil. Methods Secondary data from a national program obtained through interviews with users were analyzed. Satisfaction was based on the Swan’ model relating to perceptions regarding the service performance, assessment of overall satisfaction and the intention to avoid the service in the future. The exploratory variables were demographic characteristics of the users and the quality of the primary service from the user’s viewpoint, considering the dimensions: access; receptivity of spontaneous demand; integral health care; bonding, accountability, and coordination of care. Results A total of 37,262 users participated, and 65.51% reported satisfaction with the oral health service, that was higher among those > 20 years old and beneficiaries of the Family Grant Program and lower among users with a higher level of schooling and those who reported being employed. Users who rated oral health service positively were more satisfied. Conclusions Socioeconomically disadvantaged user was more satisfied with oral health services and the satisfaction increased with age. The improvement in the quality of oral health services in primary care can result in greater satisfaction.
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Affiliation(s)
| | - Maria Inês Barreiros Senna
- Department of Dental Clinic, Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
| | - Gizelton Pereira Alencar
- Department of Epidemiology, Faculty of Public Health, University of São Paulo, São Paulo, Brazil
| | | | - Janice Simpson de Paula
- Department of Community and Preventive Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Raquel Conceição Ferreira
- Department of Community and Preventive Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Alrawiai S, Asimakopoulou K, Scambler S. Dentists' perceptions of a practical model of patient-centred care: providing information and choice in a dental consultation. PSYCHOL HEALTH MED 2019; 24:1090-1099. [PMID: 30900479 DOI: 10.1080/13548506.2019.1595682] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Adopting a patient-centred approach when engaging with patients has been linked to positive outcomes in medicine. However, in the field of dentistry, patient-centred care (PCC) has been understudied. The aim of this study was to explore dentists' opinions about the usefulness of a theoretical model of PCC and its applicability to a dental setting. Twenty semi-structured interviews were conducted with dentists working at a major university hospital in south London. The interviews were audiotaped and analysed using thematic analysis. The analysis showed that dentists found the PCC model to be useful for practical application but mostly for 'other' dentists. They viewed the lowest and highest levels of PCC that the model advocates as 'out-dated' and 'ideal', respectively. Dentists felt that giving patients full choice and control over their treatment was not applicable to everyday clinical practice. They expressed that a tool developed on the basis of this hierarchy of PCC could be useful for self-assessment purposes, although with some reservations. In conclusion, dentists seemed to embrace the practice of PCC and felt that their provision of PCC was at an acceptable standard. They believed that a moderate level of information and choice was most suitable for patients.
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Affiliation(s)
- Sumaiah Alrawiai
- a King's College London, Dental Institute, Division of Population and Patient Health, Social and Behavioural Sciences Group , Guy's Hospital , London , UK
| | - Koula Asimakopoulou
- a King's College London, Dental Institute, Division of Population and Patient Health, Social and Behavioural Sciences Group , Guy's Hospital , London , UK
| | - Sasha Scambler
- a King's College London, Dental Institute, Division of Population and Patient Health, Social and Behavioural Sciences Group , Guy's Hospital , London , UK
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Lee H, Chalmers NI, Brow A, Boynes S, Monopoli M, Doherty M, Croom O, Engineer L. Person-centered care model in dentistry. BMC Oral Health 2018; 18:198. [PMID: 30497465 PMCID: PMC6267887 DOI: 10.1186/s12903-018-0661-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 11/12/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To achieve optimal health and oral health, the system of care must place a person and their social well-being at the center of decision making and understand factors spent outside the clinical settings, including individual behavior, context and lifestyle. MAIN TEXT Person-centered care offers a unique and compelling opportunity for dentistry, and its practitioners, to improve quality of care and overall health outcomes. For decades, the dominant treatment modalities within dentistry primarily focused on a surgical, treatment-oriented approach as opposed to health promotion and improvement. However, new business and care models are disrupting the dental care system, and transforming it into one that is focused on disease management and prevention-oriented primary care that considers overall health and well-being. We proposed a person-centered care model to improve oral health as an integral part of overall health. The model identified three key players who act as change agents with their respective roles and responsibilities: Person, provider, and health care system designer. CONCLUSIONS While previous person-centered models in dentistry focused on the role of providers within the clinical setting, this work emphasizes the role of the care designer in creating an environment where both person and provider are able to communicate effectively and achieve improved health outcomes.
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Affiliation(s)
- Hyewon Lee
- DentaQuest Institute, 10320 Little Patuxent Pkwy., Suite 200, Columbia, MD 21044 USA
- AcademyHealth, 1666 K Street NW, Suite 1100, Washington, DC, 20006 USA
| | - Natalia I. Chalmers
- DentaQuest Institute, 10320 Little Patuxent Pkwy., Suite 200, Columbia, MD 21044 USA
- Present address: U.S. Food and Drug Administration, Silver Spring, USA
| | - Avery Brow
- DentaQuest Institute, 10320 Little Patuxent Pkwy., Suite 200, Columbia, MD 21044 USA
| | - Sean Boynes
- DentaQuest Institute, 2400 Computer Dr, Westborough, MA 01581 USA
| | | | - Mark Doherty
- Safety Net Solutions, DentaQuest Institute, 2400 Computer Dr, Westborough, MA 01581 USA
| | - Olivia Croom
- DentaQuest Foundation, 465 Medford St, Boston, MA 02129 USA
| | - Lilly Engineer
- Department of Anesthesia and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205 USA
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 600 N. Wolfe St, Baltimore, MD 21205 USA
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Maassen EF, Regeer BJ, Regeer EJ, Bunders JFG, Kupka RW. The challenges of living with bipolar disorder: a qualitative study of the implications for health care and research. Int J Bipolar Disord 2018; 6:23. [PMID: 30397833 PMCID: PMC6218397 DOI: 10.1186/s40345-018-0131-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 08/22/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND In mental health care, clinical practice is often based on the best available research evidence. However, research findings are difficult to apply to clinical practice, resulting in an implementation gap. To bridge the gap between research and clinical practice, patients' perspectives should be used in health care and research. This study aimed to understand the challenges people with bipolar disorder (BD) experience and examine what these challenges imply for health care and research needs. METHODS Two qualitative studies were used, one to formulate research needs and another to formulate healthcare needs. In both studies focus group discussions were conducted with patients to explore their challenges in living with BD and associated needs, focusing on the themes diagnosis, treatment and recovery. RESULTS Patients' needs are clustered in 'disorder-specific' and 'generic' needs. Specific needs concern preventing late or incorrect diagnosis, support in search for individualized treatment and supporting clinical, functional, social and personal recovery. Generic needs concern health professionals, communication and the healthcare system. CONCLUSION Patients with BD address disorder-specific and generic healthcare and research needs. This indicates that disorder-specific treatment guidelines address only in part the needs of patients in everyday clinical practice.
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Affiliation(s)
- Eva F. Maassen
- Athena Institute, Faculty of Earth and Life Sciences, VU University Amsterdam, Boelelaan 1085, 1081HV Amsterdam, Netherlands
- Altrecht Institute for Mental Health Care, Nieuwe Houtenseweg 12, 3524 SH Utrecht, Netherlands
| | - Barbara J. Regeer
- Athena Institute, Faculty of Earth and Life Sciences, VU University Amsterdam, Boelelaan 1085, 1081HV Amsterdam, Netherlands
| | - Eline J. Regeer
- Altrecht Institute for Mental Health Care, Nieuwe Houtenseweg 12, 3524 SH Utrecht, Netherlands
| | - Joske F. G. Bunders
- Athena Institute, Faculty of Earth and Life Sciences, VU University Amsterdam, Boelelaan 1085, 1081HV Amsterdam, Netherlands
| | - Ralph W. Kupka
- Altrecht Institute for Mental Health Care, Nieuwe Houtenseweg 12, 3524 SH Utrecht, Netherlands
- Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, De Boelelaan 1117, Amsterdam, Netherlands
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Raittio E, Lahti S, Suominen AL. Adult Finns' perceptions about communication with the dentist during their latest visit. Community Dent Oral Epidemiol 2018; 47:112-118. [PMID: 30370968 DOI: 10.1111/cdoe.12431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 07/27/2018] [Accepted: 10/01/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of this study was to investigate adult Finns' perceptions about communication with the dentist during their latest visit in three aspects: receiving adequate information about health status and care, being listened to and shown interest by the dentist, and being able to influence the treatment decisions. METHODS Data were taken from the Health 2011 Survey (BRIH8901). A representative sample (n = 5806) of adult Finns aged over 29 years old was interviewed or alternatively filled in a questionnaire. Basic descriptive tabulations, Rao-Scott chi-square tests and logistic regression analyses were used to study how socioeconomic status, perceived oral health and oral Health care variables are associated with the three aspects of communication with the dentist. RESULTS Most (85%-90%) adult Finns felt that, during their latest visit to a dentist, they had received adequate information, were listened to and shown interest by their dentist, and that they had been able to influence the treatment decisions. Those who perceived poor oral health, felt visiting dentist somewhat frightening, were in a difficult economic situation, visited a public dentist, or tended to visit oral Health care services irregularly, felt more often that there was a deficit in communication with the dentist. CONCLUSIONS In 2011, most adult Finns did not report any deficit in communication with the dentist during their latest visit. Oral Health care professionals should focus more on communicating with patients who have economic problems, poor oral health, dental fear or a problem-oriented visiting pattern.
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Affiliation(s)
- Eero Raittio
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Keski-Satakunta's Health Care Federation of Municipalities, Harjavalta, Finland
| | - Satu Lahti
- Institute of Dentistry, University of Turku, Turku, Finland.,Turku Clinical Research Centre, Turku University Hospital, Turku, Finland
| | - Anna Liisa Suominen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Public Health Evaluation and Projection Unit, National Institute for Health and Welfare (THL), Helsinki, Finland.,Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
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Epifania E, Sanzullo R, Sorrentino R, Ausiello P. Evaluation of Satisfaction Perceived by Prosthetic Patients Compared to Clinical and Technical Variables. J Int Soc Prev Community Dent 2018; 8:252-258. [PMID: 29911064 PMCID: PMC5985683 DOI: 10.4103/jispcd.jispcd_27_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 03/29/2018] [Indexed: 11/09/2022] Open
Abstract
Objectives: The purpose of this study is to relate the clinical quality of the complete denture and specific anamnestic factors to the level of satisfaction perceived by patients. Also identifying possible prognostic parameters that could be predictive of future satisfaction. Materials and Methods: On the basis of a substantial existing literature, the most appropriate parameters to determine the prosthetic quality have been determined to evaluate the satisfaction perceived by patients about their denture; a completely new questionnaire has been drawn up. Ninety-eight patients have been included in the research, they have undergone a clinical examination, and they have filled out the questionnaire anonymously. The ANOVA test and Pearson correlation test have been employed to relate clinical and anamnestic factors to the overall satisfaction score. Results: The average level of patients’ satisfaction was between “quite satisfied” and “very satisfied.” There is no significant variability of satisfaction related to the type of prosthesis. The ANOVA test did not verify relationships between the overall satisfaction score and the anamnestic data examined. Pearson linear correlation coefficient between the overall prosthetic quality and the general satisfaction perceived by patients is 0.493 (P < 0.01). Extension of the prosthetic body (r = 0.478; P < 0.01) and retention (r = 0305; P < 0.05) are in correlation with the overall patients’ satisfaction. Conclusion: there is a moderately strong relationship between the overall prosthetic quality and the general satisfaction perceived by patients. Particularly, the retention and the adequate extension of the prosthetic body appear to be factors that are most associated with satisfaction. Instead, the anamnestic factors are not related to overall satisfaction score.
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Affiliation(s)
- Ettore Epifania
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Dentistry, University of Naples Federico II, Naples, Italy
| | - Roberto Sanzullo
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Dentistry, University of Naples Federico II, Naples, Italy
| | - Roberto Sorrentino
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Dentistry, University of Naples Federico II, Naples, Italy
| | - Pietro Ausiello
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Dentistry, University of Naples Federico II, Naples, Italy
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Luo JYN, Liu PP, Wong MCM. Patients' satisfaction with dental care: a qualitative study to develop a satisfaction instrument. BMC Oral Health 2018; 18:15. [PMID: 29382318 PMCID: PMC5791245 DOI: 10.1186/s12903-018-0477-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 01/24/2018] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND To explore and better understand how patients evaluate satisfaction in dental care and elicit information from them to develop a dental satisfaction instrument. METHODS Patients currently receiving dental treatment in a teaching hospital were invited to be part of a qualitative research project which involved focus group discussion. Focus groups were conducted in Cantonese and discussions were recorded (audio and video) and later transcribed. RESULTS Thirty patients participated and a thematic analysis of data from four focus groups helped generate a questionnaire on dental satisfaction. Six themes were extracted from the contents of the focus group: (i) attitude, (ii) cost, (iii) convenience, (iv) pain management, (v) quality, and (vi) patients' perceived need for prevention of oral disease. Compared to the existing Dental Satisfaction Questionnaire (DSQ), majority of the dental satisfaction aspects mentioned in focus group discussions were similar to items in DSQ supporting its content validity. Focus groups covered more aspects including attitude of dental supporting staff, convenience of emergency services, admission of patients and treatment duration. Consideration of the clinical skills of the operator, hospital infection control, and knowledge on prevention of oral disease were also expressed. CONCLUSIONS The focus group discussions elicited the views of patients not covered by DSQ items thereby suggesting areas for development of a new satisfaction questionnaire.
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Affiliation(s)
- Jennifer Yu Ning Luo
- Dental Public Health, Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong
- Department of Stomatology, The Yiwu Hospital Affiliated to Wenzhou Medical College, 699 Jiangdong Road, Yiwu, Zhejiang Province China
| | - Pearl Pei Liu
- Dental Public Health, Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong
| | - May Chun Mei Wong
- Dental Public Health, Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong
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Zhu S, Jayaraman J, Khambay B. Evaluation of Facial Appearance in Patients with Cleft Lip and Palate by Laypeople and Professionals: A Systematic Literature Review. Cleft Palate Craniofac J 2018; 53:187-96. [DOI: 10.1597/14-177] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Objective To identify whether laypeople and professionals rate the facial appearance of patients with cleft lip and palate (CLP) similarly based on viewing full facial images. Design Several electronic databases were searched. A hand search was performed among reference lists and relevant journals. Studies that assessed the full facial appearance of patients with CLP based on two-dimensional (2D) photographs, 3D images, or clinical examination by laypeople and professionals using a visual analog scale (VAS) or a categorical rating scale were included. Two authors independently assessed articles using methodologic-quality scoring protocol. Result Eleven articles were included in qualitative synthesis, including four high-level and seven moderate-level papers. Three studies found that laypeople were more critical than professionals, three found there was no significant difference between laypeople and professionals, and five reported that professionals were more critical than laypeople when assessing facial appearance of patients with CLP. Conclusions It still remains unknown whether laypeople are more or less critical than professionals when rating facial appearance of patients with repaired CLP. Professionals are more familiar with the esthetic outcomes and difficulties of treating patients. The opposite maybe true for laypeople; this disparity between what is achievable by professionals and what is expected by laypeople may be a source of dissatisfaction in facial appearance outcome. Further well-designed studies should be carried out to address this question and the clinical significance of the difference in rating scores for patients with CLP.
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Affiliation(s)
- Shiwen Zhu
- Discipline of Orthodontics and Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Jayakumar Jayaraman
- Discipline of Orthodontics and Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Balvinder Khambay
- Discipline of Orthodontics and Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR
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Abstract
The unpredictability of unscheduled emergency dental care carries its own clinical, communication and management challenges with associated medico-legal risks. Providing emergency dental treatment for unfamiliar patients in an unfamiliar environment amplifies the hidden pitfalls which failure to avoid can create potentially damaging critical incidents in a practitioner's professional life. These are preferably avoided through consistent attention to best practice and risk management. Day to day processes, such as excellent record-keeping, valid consent and effective communication are under the spotlight in the event that a patient complains, raises a concern with a regulator or seeks compensation following alleged negligent care. This paper aims to highlight the dento-legal pitfalls that may be pertinent in such a challenging situation.
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Yeung CA. Literature reviews: Patient-centred care. Br Dent J 2017; 222:141-142. [DOI: 10.1038/sj.bdj.2017.98] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Impact of Prominent Themes in Clinician-Patient Conversations on Caregiver's Perceived Quality of Communication with Paediatric Dental Visits. PLoS One 2017; 12:e0169059. [PMID: 28046044 PMCID: PMC5207641 DOI: 10.1371/journal.pone.0169059] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 12/09/2016] [Indexed: 11/19/2022] Open
Abstract
Patients’ perceived satisfaction is a key performance index of the quality health care service. Good communication has been found to increase patient’s perceived satisfaction. The purpose of this study was to examine the impact of the prominent themes arising from clinician-patient conversations on the caregiver’s perceived quality of communication during paediatric dental visits. 162 video recordings of clinical dental consultations for 62 cases attending the Paediatric Dentistry Clinic of The Prince Philip Dental Hospital in Hong Kong were captured and transcribed. The patients’ demographic information and the caregiver’s perceived quality of communication with the clinicians were recorded using the 16-item Dental Patient Feedback on Consultation skills questionnaires. Visual text analytics (Leximancer™) indicated five prominent themes ‘disease / treatment’, ‘treatment procedure related instructions’, ‘preparation for examination’, ‘positive reinforcement / reassurance’, and ‘family / social history’ from the clinician-patient conversation of the recorded videos, with 60.2% of the total variance in concept words in this study explained through principal components analysis. Significant variation in perceived quality of communication was noted in five variables regarding the prominent theme ‘Positive reinforcement / reassurance’: ‘number of related words’ (p = 0.002), ‘number of related utterances’ (p = 0.001), ‘percentage of the related words in total number of words’ (p = 0.005), ‘percentage of the related utterances in total number of utterances’ (p = 0.035) and ‘percentage of time spent in total time duration’ (p = 0.023). Clinicians were perceived to be more patient-centered and empathetic if a larger proportion of their conversation showed positive reinforcement and reassurance via using related key words. Care-giver’s involvement, such as clinicians’ mention of the parent, was also seen as critical to perceptions of quality clinical experience. The study reveals the potential of the application of visual text analytics software in clinical consultations with implications for professional development regarding clinicians’ communication skills for improving patients’ clinical experiences and treatment satisfaction.
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